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General NPI Number Information
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NPI Number | 1912661976
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Entity Type | Organization
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Legal Business Name | GAY M JENSEN, RDH, PLLC
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Dates
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Enumeration Date | 10/26/2021
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 16422 GIBSON RD SW
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City | TENINO
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State | WA
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Zip | 98589-9719
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Country | US
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Telephone | 360-791-9969
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Fax | 866-742-7980
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Provider Business Mailing Address
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Address Line | 3701 PACIFIC AVE SE STE 317
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City | OLYMPIA
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State | WA
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Zip | 98501-2124
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Country | US
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Telephone | 360-791-9969
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Fax | 866-724-7980
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Authorized Official
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Title or Position | OWNER/DENTAL HYGIENIST
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Name | GAY M JENSEN
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Credential | RDH, PLLC
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Telephone | 360-791-9969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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